The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

No abstract available.
Clonidine* ; Depression* ; Growth Hormone* ; Humans ; Panic Disorder* ; Panic*

We report a case of morphea profunda in a 21-year-old male who had diffuse brown sclerotic plaques on his extremities. Laboratory findings showed peripheral eosinophilia and an increased titers for anti-DNA and anti-nuclear antibodies. Histopathologic findings showed diffuse fibrosis and a thickening of the lower dermis and subcutaneous tissue. He has been treated with hydroxychloroquine 400mg per day and the sclerosis of the skin improved.
Antibodies ; Dermis ; Eosinophilia ; Extremities ; Fibrosis ; Humans ; Hydroxychloroquine ; Male ; Scleroderma, Localized* ; Sclerosis ; Skin ; Subcutaneous Tissue ; Young Adult

We analysed the results of total knee replacement arthroplasty without patellar resurfacing in 20 patients(28 knees) retrospectively. The patella was not resurfaced when it maintained relatively healthy cartilage in osteoarthritis or the patella was too thin to be replaced in rheumatoid arthritis. The diagnoses were osteoarthritis in 11 and rheumatoid arthritis in 17 cases. The follow up period was 30.3 months in average(12-70 months). A lateral retinacular release was performed in 22 knees(78.6%). The mean knee society score improved from 45.4 preoperatively to 84.1 postoperatively and the functional score improved from 21.4 preoperatively to 63.3 postoperatively. The modified Kujala score was 43.2 points in osteoarthritis and 43.6 points in rheumatoid arthritis. We conclude the total knee replacement arthroplasty without patellar resurfacing shows good results, without high risk of postoperative peripatellar complication.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Cartilage ; Diagnosis ; Follow-Up Studies ; Knee ; Osteoarthritis ; Patella ; Retrospective Studies

Keratosis punctata of the palmar creases (KPPC) is rare skin condition characterized by punctiform hyperkeratotic pits confined to the palmar and digital creases. Although this condition has been regarded as a variant of classical punctate keratoses, there are some differences between classical punctate keratosis and KPPC. We herein report a case of KPPC in a 22-year-old man who had numerous, tiny, hyperkeratotic pits limited to the palmar creases of both hands with typical histologic findings.
Hand ; Humans ; Keratosis* ; Skin ; Young Adult

Fibrous hamartoma of infancy (FHI) is an uncommon, benign, solitary intradermal or subcutaneous tumor. It occurs typically in the axillary or shoulder region. The histopathologic examination of affected lesion shows the characteristic elements: dense fibrous tissue, adipose tissue, and primitive mesenchymal tissues. A 15 month-old girl had the multiple, asymptomatic, discrete, and skin-colored tumors that scattered on the scalp. These were present at birth. We report a rare case of FHI occurred on the scalp with multiple and congenital characteristics.
Adipose Tissue ; Female ; Hamartoma* ; Humans ; Parturition ; Scalp ; Shoulder

No abstract available.
Humans ; Lung Neoplasms* ; Lung*

No abstract available.
Fistula*

BACKGROUND AND OBJECTIVES: Cholesteatoma is a disease of the temporal bone, affecting the squamous epithelium and invading into the middle ear cavity. Retinoic acid (RA) is known to inhibit or accelerate the proliferation of normal keratinocytes depending on its concentration. This study was aimed at investigating the effects of different concentrations of RA on the proliferation of cultured keratinocytes from the external ear and cholesteatoma and whether the effect is different according to the origin of tissue. MATERIALS AND METHODS: Patients undergoing tympanomastoid surgery for cholesteatoma were selected, and cholesteatoma matrix and skin were obtained from their middle ears and external ears, respectively. After culturing keratinocytes from the external ear and cholesteatoma, cells were cultured for 7 days in the medium 154 (Cascade, USA), and 10(-6)M RA or 10(-7)M RA was added twice every three days. The control group was cultured without the addition of RA. The absorbance was estimated at 490 using CellTiter 96(TM)AQ(ueous) Non-Radioactive Cell Proliferation Assay, nm and the survival fraction was calculated and compared with the control group. RESULTS: Proliferation of keratinocytes from the external ear and cholesteatoma was inhibited when the concentration of RA was 10-6 M and accelerated when the concentration of RA was 10(-7)M. The accelerated effect of retinoic acid on the proliferation of keratinocyte seems to be less prominent in the cholesteatoma tissue than in the skin of normal ear canal. CONCLUSION: Retinoic acid can inhibit or accelerate the proliferation of cholesteatoma keratinocytes dependining on its concentration.
Cell Proliferation ; Cholesteatoma* ; Ear Canal ; Ear, External* ; Ear, Middle ; Epithelium ; Humans ; Keratinocytes* ; Skin ; Temporal Bone ; Tretinoin*

The foreign bodies in the upper GI tract are produced chiefly by accidental swallowing and rarely produce symptoms. But it is recommended to remove the foreign bodies if they produce symptoms or retained in GI tract for long duration, and if they have the possibilities of producing complications. Nowadays the development of therapeutic endoscopy enables the removal of the foreign bodies easily. We have reviewed 88 cases of foreign bodies diagnosed by endoscopy from January, 1980 to July 1990 and had the following results. 1) The most common foreign bodies were coins and bezoars, common with the ages under 10 years and over 50 years. 2) The foreign bodies were found in the upper gastrointestinal tract in the order of stomach, esophagus and duodenum. 3) The esophageal stricture especially by lye was the most common underlying cause of upper gastrointestinal foreign bodies. 4) The symptoms and complications were more common with esophageal foreign bodies. 5) By therapeutic endoscopy, the success rate for removal of foreign bodies was 98%.
Bezoars ; Deglutition ; Duodenum ; Endoscopy* ; Esophageal Stenosis ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Lye ; Numismatics ; Stomach ; Upper Gastrointestinal Tract*